It is well known that colonoscopies save lives. By finding and removing pre-cancerous polyps, known as adenomas, your gastroenterologist is directly reducing your risk of colon cancer. Remove a polyp and it cannot become a cancer.
We also know that the quality of a colonoscopy hinges on the Adenoma Detection Rate (or ADR). Simply put, the ADR is a gastroenterologist’s polyp detection score. He or she should find a minimum of 25 adenomas in every 100 colonoscopies (an ADR of 25%). The ADR is an established quality measure for gastroenterologists.
What you need to understand is that there is significant variability in ADRs between different gastroenterologists. In fact, large studies show that physicians with the highest ADRs find 3 times as many polyps as those with the lowest ADRs. You could imagine that removing more polyps translates into fewer cancers later on (or on the flip side: if polyps are missed, they may become cancers). This fact was long assumed, but is now confirmed by 2 pivotal studies.
The first, published in the New England Journal of Medicine, showed that patients who are treated by physicians with the lowest ADRs have a 60% higher risk of dying from colon cancer, compared to patients treated by physicians with the highest ADRs. Adenoma detection rate and risk of colorectal cancer and death
The second study, published last month in the Journal of the American Medical Association, confirmed that higher ADRs were associated with a significantly lower lifetime risk of colon cancer and death. Variation in Adenoma Detection Rate and the Lifetime Benefits and Cost of Colorectal Cancer Screening: A Microsimulation Model
What these studies tell us is that we, as gastroenterologists, need to do our absolute best to find all polyps. We should be exceeding the minimum benchmark ADR. And as a patient, you should ask about your gastroenterologist’s ADR and recognize the importance it may have on your health. At Cary Gastroenterology, we track and report our adenoma detection rates. Click below to see our numbers:
Bottom line: Your gastroenterologist’s adenoma detection rate matters. A thorough colonoscopy can save your life. Make sure you are receiving the best possible exam.
-Christopher McGowan, MD